Provider Demographics
NPI:1427375732
Name:MARINAC, JACQUELINE SUE (BS, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:SUE
Last Name:MARINAC
Suffix:
Gender:F
Credentials:BS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13000 W 87TH STREET PKWY
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-4634
Mailing Address - Country:US
Mailing Address - Phone:913-492-3311
Mailing Address - Fax:913-492-0088
Practice Address - Street 1:13000 W 87TH STREET PKWY
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-4634
Practice Address - Country:US
Practice Address - Phone:913-492-3311
Practice Address - Fax:913-492-0088
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0430951835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist